Surviving the First Weeks of Nursing

By Emily McIntyre

Three days after my daughter was born, I found myself staring into the mirror while tears ran down my cheeks, stunned by the sight of my breasts. Tender beyond belief, they were actually as large as cantaloupes. I’d heard about engorgement and knew it was common, but never dreamed how agonizing it could be.

It took several days of constant nursing and pumping to bring things to a new normal, for the hard and shiny bowling balls attached to my chest to shrink, and for the idea that I had become a nursing mother to settle in. It was at least three weeks before I could handle the initial latch-on without gasping, and longer still for the shooting pains of my milk letting down to subside somewhat.

Making the transition into a successful nursing relationship with your newborn can be tough. The physical strain, the tenuous emotional state post-delivery and the burden of providing sole nourishment for a tiny human being can be overwhelming. Here are some of the issues I’ve encountered in the first three months of nursing, as well as some thoughts on dealing with them.

First Nursing

It was scary, and odd, to nurse my daughter for the first time. In my dazed state, her tiny frame seemed unreal; holding her felt both incredible and strange at once. Such a wild sensation it seemed, her small searching mouth drawing nourishment from a very private part of my body.

Don’t feel guilty or too upset if the first nursing, or even many subsequent ones, are difficult in more ways than one. Nursing is a learned skill for both Mom and Baby. It may take time, and it will most definitely feel strange and probably hurt for awhile. There are few problems, however, that can’t be resolved with the help of both a lactation consultant and plain determination.

A word to the wise—use lanolin on your nipples after every feeding, even if they don’t hurt. You’ll be glad later, as it will reduce cracking and bleeding of tender skin.

Milk Coming In & Engorgement

In two or three days, your milk will come in—that is, it will change from low-volume, very rich colostrum to a deluge of thinner milk for your babe’s expanding stomach. The baby will start to make distinctive suck-suck-swallow sounds when nursing. You’ll notice that your breasts begin to feel heavier. You may have discomfort for awhile, until your baby’s demand regulates your supply.

If you start to notice signs of engorgement—milk ducts swollen and painful into your armpits, extreme swelling of the breasts to the point where latch-on is difficult for your baby, shiny skin—you need to address them in order to avoid infection. Remove as much milk as possible frequently (every 1 ½ to 2 hours.) Standing in a hot shower and hand-expressing milk (massage gently, squeeze the areola) until your breasts are empty can help. Hot compresses before nursing and cold ones after can reduce pain and inflammation. Rest and drink lots of water. Don’t be afraid of interfering with your milk supply at this time; your goal needs to be to get through engorgement and on to normal nursing.

Overactive Letdown & Hindmilk/Foremilk Imbalance

We survived engorgement, but I became concerned because my daughter would choke, gasp, cry and pull away from the breast constantly during feeding. She also seemed to have terrible, painful gas and was hard to burp. Eventually, we realized that I had an overactive letdown, which was causing the milk to spray against the back of her throat and trigger her gag reflex. I began hand-expressing milk onto a towel until the let-down slowed, which helped with the choking. I also wasn’t nursing her long enough on each breast, so she was getting too much foremilk and not enough of the richer hindmilk, an imbalance which caused intestinal distress. Once we started nursing each side until it was empty (for me, this means using one breast per feeding), she became an easy-to-burp baby and seemed to have much less stomach pain. As always, check with your doctor on any questions or concerns you may have.

In my next article, I will address staying sane during night feedings, heading off plugged ducts and mastitis, handling growth spurts and nursing in public.

New mom Emily McIntyre is becoming an expert in nursing and she and her infant daughter learn together.